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Understanding antibiotic use in livestock systems is key in combating antimicrobial resistance (AMR) and developing effective interventions. Using a standardised questionnaire, we investigated the patterns and drivers of antibiotic use in 165 cattle farms across the three major cattle production systems in Kenya: intensive, extensive, and semi-intensive systems across in three counties: Machakos, Makueni and Narok in Kenya. We used a causal diagram to inform regression models to explore the drivers of antibiotic use in the study farms. Antibiotic use was reported in 92.7% of farms, primarily for prophylactic purposes. Oxytetracycline, penicillin, and streptomycin were the most used antibiotics to treat and control the most reported diseases including mastitis, diarrhoea and East Coast fever (ECF). Regression analysis indicated a positive association between the frequency of antibiotic use at the farm level and both disease incidence and herd size. Conversely, farms that provided cattle with appropriate housing were less likely to use antibiotics, and there was no difference in antibiotic use between those who consulted with veterinarians or sourced antibiotics directly from animal health providers. Our study highlights the complexities around understanding the interplay between practices and drivers of antibiotic use. It also underscores the necessity to enhance education regarding the appropriate usage of antibiotics among cattle farmers, encourage the adoption of proper herd management practices which may reduce disease burden, and reinforce veterinary services and supportive legislation to promote the prudent use of antimicrobials.

Objectives: HLA-DRB1 is associated with an increased risk of cardiovascular disease in patients with rheumatoid arthritis (RA). This study aimed to determine the effect of HLA-DRB1 on atherosclerotic cardiovascular disease (ASCVD) using a novel mouse model. Methods: Mice transgenic for HLA-DRB1*04:01 (DR4tg) were crossed with low density lipoprotein receptor knock-out (Ldlr−/−) mice that develop atherosclerosis when fed a high fat, high cholesterol (HFHC) diet. Male and female DR4tgLdlr−/− (n = 48), Ldlr−/− (n = 24), DR4tg (n = 24), and C57Bl/6 (B6) background (n = 24) mice were fed HFHC or regular diet (RD) for 12 weeks. Blood samples were analyzed for serum lipoproteins using a colorimetric assay. C-reactive protein (CRP) and oxidized LDL (OxLDL) were measured using ELISA. Atherosclerosis in the aortas was assessed using the lipid stain, Sudan IV. The presence of citrulline in atherosclerotic plaque was determined by immunohistochemistry. Results: Sera low-density lipoprotein cholesterol (LDL-C) levels were higher in HFHC-fed Ldlr−/− versus DR4tgLdlr−/−-; p = 0.0056, but the aortic plaque burden and degree of citrullination in the plaque were similar for these two strains. The ratio of pro-atherogenic OxLDL to LDL levels was higher in DR4tgLdlr−/− than Ldlr−/−mice; p = 0.0017. All mice had an increase in CRP when fed a HFHC diet, most pronounced for DR4tgLdlr−/−; p = 0.0009. There were no significant sex differences for DR4tgLdlr−/− mice; however, male Ldlr−/− mice had worse atherosclerosis. B6 and DR4tg mice did not have significant elevations in serum cholesterol levels and did not develop atherosclerosis. Conclusions: Expression of HLA-DRB1 resulted in an elevation of OxLDL and a reduction in the male bias for atherosclerosis, mimicking what is observed in RA.

The plights of Internally Displaced Persons (IDPs), including hunger, rape, insecurity, and death, have assumed a frightening dimension in North-eastern Nigeria with the sustained intervention of the National Emergency Management Agency (NEMA) to ameliorate their sufferings. This paper aimed to assess the response capacity of NEMA to the plights of the IDPs in North-eastern Nigeria. The objectives of the study were to examine the nature and dimensions of the plights of the IDPs in the Northeast, identify their coping strategies, and assess the impact of NEMA's response strategies on the burgeoning situation. The study used a qualitative survey research design, in which 166 key Informant Interviews (KII) were conducted. The primary designs were complemented by secondary data, which was derived from books, journal articles, and News tabloids. Data generated were descriptively analyzed. Major findings from the paper were that the Boko Haram insurgency was primarily responsible for the mass displacement of persons in North-eastern Nigeria. The IDPs are facing lots of challenges in the camps with weak coping strategies while the intervention of NEMA through the provision of relief materials, rehabilitation and resettlement programs, and linking of the displaced with family members have reduced the plights of the IDPs. However, the Agency currently has the minimal operational capacity to ameliorate the plights of the IDPs due to the protracted nature of the insurgency, legal restriction on the operational mandates of NEMA, corruption, and limited funding of the agency. The Study recommended improved funding of the Agency and enactment of IDP-specific constitutional roles for maximum impact of NEMA on the amelioration of the plights of the IDPs in North-Eastern Nigeria.

The experimental study of vibrating plates having simply-supported boundary conditions can be difficult to achieve due to the complexity of preventing translation, but allowing rotation along all boundaries simultaneously. Only a few methods have been proposed, but all are either time-consuming to set up and involve customization of the test rig for each plate or do not allow the plate to be reused for other purposes. The method described in this paper offers a low-cost, simple, accurate and non-destructive way of experimentally measuring the modal properties of thin, simply supported plates and can be used for quick validations of models and designs without modification for multiple trials and varying plate properties. The key attributes of this method include: • An adjustable sliding support frame which can be made of a distinct material from the plate and which can accommodate variations in plate geometry and properties without modification. • Removable flexible sealant applied in a v-groove on the supporting frame which can be easily used to fix and support the plate according to the simply-supported boundary conditions. • A low-profile design, which can be used to accommodate most experimental testing methods for determining modal properties of vibrating plates. Method name: Non-destructive and reusable simply-supported plate vibration test method, Keywords: Experimental measurements, Flexible test rig, Reusable specimens, Simply supported boundary conditions, Kirchhoff plates, Ribbed plates

Background: Ghana implemented a nationwide health insurance scheme in 2005 as part of efforts to ensure access to affordable and equitable health care without paying user fees at the point of service delivery. However, active enrolment has remained low even over a decade of implementing this policy. We aimed to understand some of the factors accounting for low active enrolment by examining the possibility that unawareness of insurance status could be a contributor among women from an impoverished rural setting. Methods: We used cross-sectional data from reproductive-aged women from one of Ghana's poorest and remote regions. A two-stage sampling approach was used. First, the Ghana Statistical Service purposefully sampled and provided 66 predominantly rural enumeration areas from all districts the Upper East region except Kassena-Nankana East and West Districts. Guided by this sampling frame, a household listing of members in the sampled enumeration areas was done. Second, we sampled households proportional to the population size. Within sampled households, all females between the ages of 15 and 49 years were eligible to be interviewed. In the case of the two Kassena-Nankana Districts, sampling was done using Navrongo Health Research Center demographic surveillance data, from which a random sample of 2500 women was sampled. During the survey, two questions related to the National Health Insurance Scheme (NHIS) were asked: “Have you ever registered with the NHIS?” and “Do you currently have a valid NHIS card?” If the answer to the second question was yes, the interviewer requested to see the card and confirm its validity (cards must be renewed annually). We examined the prevalence and predictors of unawareness of health insurance status using descriptive statistics, a χ2 test of association, and regression analysis. Findings: Data collection started on Oct 2, 2014, and ended on Jan 31, 2015. Of the 7693 respondents, 4900 (64%) who thought that they were actively enrolled in the NHIS could produce their insurance cards upon request. 1642 (33·5%) of these had invalid cards. Factors that significantly predicted unawareness of card invalidity were occupation, district of residence, and socioeconomic status. Farmers were the most likely to be unaware of their card validity status compared with all other occupations. Residents in five out of seven districts were less likely to be unaware of their insurance card validity. There was a consistent increase in the likelihood of unawareness with decreasing socioeconomic status. Interpretation: Unawareness of insurance card invalidity is an important contributor to low active enrolment onto Ghana's national health insurance scheme. Educational campaigns aimed at improving active health insurance membership should include messages that are tailored to populations such as farmers and low socioeconomic groups. The unawareness disparities within districts in the studied region merit further investigation. Funding: Doris Duke Charitable Foundation.

Background: In 2012, WHO changed its recommendation for intermittent preventive treatment of malaria during pregnancy (IPTp) from two doses to monthly doses of sulfadoxine-pyrimethamine during the second and third trimesters, but noted the importance of a cost-effectiveness analysis to lend support to the decision of policy makers. We therefore estimated the incremental cost-effectiveness of IPTp with three or more (IPTp-SP3+) versus two doses of sulfadoxine-pyrimethamine (IPTp-SP2). Methods: For this analysis, we used data from a 2013 meta-analysis of seven studies in sub-Saharan Africa. We developed a decision tree model with a lifetime horizon. We analysed the base case from a societal perspective. We did deterministic and probabilistic sensitivity analyses with appropriate parameter ranges and distributions for settings with low, moderate, and high background risk of low birthweight, and did a separate analysis for HIV-negative women. Parameters in the model were obtained for all countries included in the original meta-analysis. We did simulations in hypothetical cohorts of 1000 pregnant women receiving either IPTp-SP3+ or IPTp-SP2. We calculated disability-adjusted life-years (DALYs) for low birthweight, severe to moderate anaemia, and clinical malaria. We calculated cost estimates from data obtained in observational studies, exit surveys, and from public procurement databases. We give financial and economic costs in constant 2012 US$. The main outcome measure was the incremental cost per DALY averted. Findings: The delivery of IPTp-SP3+ to 1000 pregnant women averted 113·4 DALYs at an incremental cost of $825·67 producing an incremental cost-effectiveness ratio (ICER) of $7·28 per DALY averted. The results remained robust in the deterministic sensitivity analysis. In the probabilistic sensitivity analyses, the ICER was $7·7 per DALY averted for moderate risk of low birthweight, $19·4 per DALY averted for low risk, and $4·0 per DALY averted for high risk. The ICER for HIV-negative women was $6·2 per DALY averted. Interpretation: Our findings lend strong support to the WHO guidelines that recommend a monthly dose of IPTp-SP from the second trimester onwards. Funding: Malaria in Pregnancy Consortium and the Bill & Melinda Gates Foundation.

In recent years larval stage zebrafish have been emerging as a standard vertebrate model in a number of fields, ranging from developmental biology to pharmacology and toxicology. The tyrosinase inhibitor 1-phenyl-2-thiourea (PTU) is used very widely with larval zebrafish to generate essentially transparent organisms through inhibition of melanogenesis, which has enabled many elegant studies in areas ranging from neurological development to cancer research. Here we show that PTU can have dramatic synergistic and antagonistic effects on the chemical toxicology of different mercury compounds. Our results indicate that extreme caution should be used when employing PTU in toxicological studies, particularly when studying toxic metal ions., (Copyright © 2015 Elsevier Inc. All rights reserved.)